Fri Oct 14 2022

90 articles - From Friday Oct 07 2022 to Friday Oct 14 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Gut

Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG) and Centre for Sustainable Health (CSH) joint consensus on practical measures for environmental sustainability in endoscopy.

In this consensus, we discuss practical measures to reduce the impact of endoscopy on the environment applicable to endoscopy units and practitioners. Adoption of these measures will facilitate and promote new practices and the evolution of a more sustainable specialty.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Urgency for bowel movements is a highly discriminatory symptom of active disease in persons with IBD (the Manitoba living with IBD study).

Urgency stood out as being consistently associated with disease activity, irrespective of the disease measure. Fatigue was the most prevalent symptom irrespective of disease activity measure. Individual symptoms have different impacts on subjective (IBDSI) and objective (FCAL) measures in IBD.

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Am J Gastroenterol

A CANADIAN PROVINCIAL SCREENING PROGRAM FOR LYNCH SYNDROME.

The first Canadian Lynch Syndrome screening program has achieved high rates of reflex testing.

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Changes in lifestyle and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition.

Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.

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Characteristics and Impact of Anxiety and Depression Trajectories in Inflammatory Bowel Disease.: Anxiety and Depression Trajectories in IBD.

In this 12-month follow-up study, patients with IBD with worsening or persistently high anxiety or depression scores were higher utilizers of healthcare but were not at increased risk of future adverse disease outcomes.

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Derivation and External Validation of Machine Learning-based Model for Detection of Pancreatic Cancer.

Using widely available parameters in EHR, we developed and externally validated parsimonious machine learning-based models for detection of pancreatic cancer. These models may be suitable for real-time clinical application.

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Incidence of Pediatric Celiac Disease Varies by Region: Celiac Disease Varies by Region.

There is high regional variability in cumulative incidence of CD which suggests differential environmental, genetic, and epigenetic influences even within the United States. The overall high incidence warrants a low threshold for screening and further research on region-specific CD triggers.

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Linaclotide Reduced Response Time for Irritable Bowel Syndrome with Constipation Symptoms: Analysis of Four Randomized Controlled Trials.

Although treatment responses with linaclotide occurred in >50% of patients with IBS-C within 4 weeks of treatment initiation, benefits for individual abdominal symptoms and/or CSBM frequency can still occur between 4 and 12 weeks. A lack of improvement in one symptom does not negate the possibility of response for others, highlighting the importance of discussing al symptoms with patients and not assuming treatment futility at 4 weeks.

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LOW RISK OF LYMPHOMA IN PEDIATRIC PATIENTS TREATED FOR INFLAMMATORY BOWEL DISEASE.

The overall lymphoma incidence was low among our cohort of treated pediatric IBD patients. We observed no cases of lymphoma among patients prescribed anti-TNF monotherapy. These findings reinforce the relative safety of anti-TNF monotherapy for the treatment of pediatric IBD.

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Medicare Patients Face High Out-of-Pocket Costs for Specialty Inflammatory Bowel Disease Medications.

OOP costs may limit many Medicare beneficiaries' access to specialty IBD medications.

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Patient knowledge, risk perception and barriers to Barrett's esophagus screening.

Patients at risk for BE, particularly racial and ethnic minorities, are worried about developing EAC but rarely undergo screening and have poor understanding of screening recommendations.

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Reduced Adenoma Miss Rate with 9-Minute vs. 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial: Nine-minute WT reduces the AMR of screening colonoscopy.

In addition to increasing ADR, 9-minute m-WT also significantly reduces the AMR and AAMR of screening colonoscopy without compromising detection efficiency.

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Time trends in colorectal cancer incidence from 1992 to 2016 and colorectal cancer mortality from 1980 to 2018 by age group and geography in Canada.

Most of Canada has not yet seen an increase in CRC burden in the 45-49 age group, which is a reason to not lower the start age for CRC screening age in Canada. Targeted CRC screening should be considered for individuals younger than 50 years of age who live in the Territories.

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Usefulness of Bifidobacterium longum BB536 in Elderly Individuals with Chronic Constipation: A Randomized Controlled Trial.

The primary endpoints were not significant. However, probiotic supplementation significantly improved bowel movements. These results suggest that B. longum BB536 supplementation is safe and partially effective for improving chronic constipation in elderly individuals.

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Clin Gastroenterol Hepatol

Environmental Pollutants are Associated with Irritable Bowel Syndrome in a Commercially Insured Cohort of California Residents.

Exposure to PM2.5 and airborne toxic releases from facilities are associated with higher IBS incidence among a cohort of commercially-insured Californians. Environmental pollutant exposure was not associated with the incidence of IBD and EoE in this cohort.

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The Spectrum and Impact of Metabolic Dysfunction in MAFLD. A Longitudinal Cohort Analysis of 32,683 Overweight and Obese Individuals.

This study reports on the heterogeneity and spectrum of metabolic dysfunction that exists in overweight and obese MAFLD. While MAFLD may be potentially be advantageous in improving awareness and patient outcomes, there remains substantial heterogeneity within patients included in MAFLD based on the underlying metabolic burden.

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Endoscopy

A Virtual Chromoendoscopy Artificial Intelligence system to detect endoscopic and histologic activity/remission and predict clinical outcomes in Ulcerative Colitis.

Our system accurately distinguished ER/activity and predicted HR and clinical outcomes from colonoscopy videos. This is the first computer model developed to detect inflammation/healing using VCE through the PICaSSO score and the first computer tool providing endoscopic, histologic, and clinical assessment.

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Development of the 'Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills' (TEAM-ENTS) behavioural marker system.

The refined TEAM-ENTS behavioural marker system was developed to reflect the core non-technical skills relevant to endoscopy teams. Future studies will aim to fully validate this tool.

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Intensive endoscopic resection for downstaging of polyp burden in patients with familial adenomatous polyposis (J-FAPP Study III): a multicenter prospective interventional study.

IDP in patients with mild-to-moderate FAP could have the potential to be a useful means of preventing colorectal cancer without implementing colectomy. However, if the IDP protocol was proposed during a much longer term, it may not preclude the possibility that a large proportion of colectomies may still need to be performed.

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Low risk of local recurrence after a successful en bloc Endoscopic Submucosal Dissection for non-invasive colorectal lesions with positive horizontal resection margins(R-ESD study).

A positive horizontal resection margin after an en bloc ESD for non-invasive lesions is associated with a marginal non-significant increase of the local recurrence rate, equal to an ESD with clear horizontal margins. This could not be confirmed for T1 lesions.

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Gastroenterology

Prospective, Multi-Institutional, Real-Time Next-Generation Sequencing of Pancreatic Cyst Fluid Reveals Diverse Genomic Alterations that Improve the Clinical Management of Pancreatic Cysts.

PancreaSeq was not only sensitive and specific for various PC types and advanced neoplasia arising from mucinous cysts, but also reveals the diversity of genomic alterations seen in PCs and their clinical significance.

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VONOPRAZAN VERSUS LANSOPRAZOLE FOR HEALING AND MAINTENANCE OF HEALING OF EROSIVE ESOPHAGITIS: A RANDOMIZED TRIAL.

(ClinicalTrials. gov:NCT04124926).

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Gastrointest Endosc

A NOVEL CLASSIFICATION SYSTEM FOR WALLED-OFF NECROSIS: A STEP TOWARD STANDARDIZED NOMENCLATURE AND RISK STRATIFICATION FRAMEWORK.

Despite the heterogeneous nature of WON in severe acute pancreatitis, a proposed QNI system may provide a standardized framework for WON classification to inform clinical trials, risk-stratify disease course, and potentially inform optimal management approach.

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Clinical outcomes of endoscopic submucosal dissection for superficial circumferential esophageal squamous cell carcinoma.

ESD is a highly curative treatment for cESCC with favorable long-term outcomes, especially in low-risk patients. Stricture-prevention techniques should be improved to optimize the benefits of ESD for cESCC.

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Closure of large mucosal defects for prevention of strictures after duodenal endoscopic submucosal dissection (with video).

Suturing may prevent post-ESD bleeding and perforation, as well as stricture formation in cases of duodenal tumors, with mucosal defects occupying a large circumference.

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Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: A randomized controlled trial.

CADe and EAC significantly improve ADR and AADR over standard colonoscopy. However, while CADe or EAC alone can substantially increase the detection of adenomas, they do not lead to increased detection of advanced adenoma unless used in combination.

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COMPUTER-ASSISTED DETECTION VERSUS CONVENTIONAL COLONOSCOPY FOR PROXIMAL COLONIC LESIONS: A MULTI-CENTER, RANDOMIZED, TANDEM COLONOSCOPY STUDY.

This multi-center trial from Asia confirmed that CADe can further enhance proximal adenoma and polyp detection, but may not be able to reduce missed proximal colonic lesions.

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Effectiveness of prophylactic clipping in preventing post-polypectomy bleeding in aspirin users - a propensity-score analysis.

Prophylactic clipping was not associated with a lower risk of PPB in aspirin users after endoscopic resection of colorectal polyps. Aspirin use should not be regarded as the only factor for the routine use of prophylactic clips.

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Endoscopic radiofrequency ablation for ingrowth occlusion following bilateral metal stenting for malignant hilar biliary obstruction: A prospective pilot study.

Endoscopic biliary RFA elicited promising results, with good long-term stent patency and without the requirement of any additional stent placement, for the palliation of ingrowth occlusion after bilateral SEMS placement. However, the clinical success rate was insufficient, necessitating improvements in the future.

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Expanding the Role of Pneumatic Dilation for Non-Achalasia Patients - A Comparative Study.

PD is an effective treatment for the non-achalasia obstructive disorders of the EGJ. There may be a current gap in training and technical expertise in PD.

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Factors predictive of persistent fistulas in EUS-Directed transgastric ERCP: A multicenter matched case-control study.

Longer LAMS dwell time was found to be associated with a higher risk of persistent fistulas in EDGE patients. APC or primary closure of the fistula on LAMS removal was not found to be protective against developing a persistent fistula, which if present, can be effectively managed through endoscopic closure in most cases.

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Motorized Spiral Enteroscopy versus Double Balloon Enteroscopy: A Case-Matched Study.

An increased frequency of adverse events was observed with MSE. There are some restriction in the indication because of the design of MSE.

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Outpatient flexible endoscopic diverticulotomy for the management of Zenker's diverticulum: a retrospective analysis of a large single center cohort.

Delayed adverse events occurred in 2.5% of cases, al of which were managed supportively. Our data are comparable to published cohorts of admitted patients, demonstrating that appropriately selected patients may be managed as outpatients while maintaining similar safety outcomes.

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SAME-SESSION ENDOSCOPIC ULTRASOUND DIRECTED TRANSGASTRIC INTERVENTION (EDGI) IN PATIENTS WITH RYGB ANATOMY: A MULTICENTER STUDY.

Single stage EDGI via a sutured 20mm LAMS was associated with high rate of technical success, low rates of adverse events and no episodes of stent migration. Persistent fistulas although common, were amenable to endoscopic management.

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Soft Self-expanding Metal Stent to Treat Painful Pancreatic Duct Strictures Secondary to Chronic Pancreatitis: A Prospective Multicenter Trial.

Six-month treatment with an FCSEMS did not lead to an expected degree of pain reduction, and migrations and SAEs were common. Further study is needed to clarify optimal decompressive strategy, FCSEMS design and patient selection.

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Usefulness of a novel computer-aided detection system for colorectal neoplasia: A randomized controlled trial.

After stratification by endoscopist and bowel cleansing, no statistically significant differences in ADR were found. Colonoscopy assisted by ENDO-AID (OIP-1) increases ADR and APC, suggesting that it may prevent the overlooking of colorectal neoplastic lesions, especially because of its detection of diminutive and flat adenomas.

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Hepatology

Diversity, equity, and inclusion in gastroenterology and hepatology: A survey of where we stand.

Our survey explored imperative and timely perspectives on racial and ethnic representation and health equity among professionals in GI and hepatology. The findings should inform future interventions to address workforce diversity and establish priorities toward improving health equity, ultimately serving as a springboard for professional societies, academic institutions, and other organizations that aim to increase diversity, equity, and inclusion in our field.

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TP53 R249S mutation in hepatic organoids captures the predisposing cancer risk.

We showed differential tumorigenic effects from TP53 loss and L3 mutations, which together confer normal hepatocytes with early clonal advantages and prosurvival functions.

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J Hepatol

Global burden of primary liver cancer in 2020 and predictions to 2040.

Liver cancer due to some causes is preventable if control efforts are prioritised. The predicted rise in cases may increase the need for resources to manage care of liver cancer patients.

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Metformin reduces hepatocellular carcinoma incidence after successful antiviral therapy in patients with diabetes and chronic hepatitis C in Taiwan.

Metformin use greatly reduced the HCC risk after successful antiviral therapy in diabetic CHC patients. A simple risk stratification composed of cirrhosis and DM non-metformin use could predict the long-term outcomes of CHC patients after SVR.

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Neurogastroenterol Motil

Associations between postprandial symptoms, hydrogen and methane production, and transit time in irritable bowel syndrome.

This study highlights the importance of oroanal transit and hydrogen and methane production in the pathophysiology of IBS and increases our understanding of pathophysiological factors involved in postprandial symptom generation. Treatments targeting oroanal transit and hydrogen and methane production may improve specific postprandial symptoms.

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Diabetes mellitus is an independent risk factor for a greater frequency of early satiation and diarrhea at one and three years: Two prospective longitudinal population-based studies.

Diabetes is an independent risk factor for a greater frequency of early satiation and diarrhea, adjusting for lifestyle and psychological factors.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: colorectal cancer in elderly-onset inflammatory bowel disease-what is the risk?

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Editorial: maternal and paternal 5-aminosalicylic acid use-safe in conception and pregnancy.

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Gastroenterology

One and done: is measurement of the rectoanal pressure gradient enough to diagnose defecatory disorders and guide the management of constipation?

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The use of intestinal ultrasound in ulcerative colitis - more than a mucosal disease?

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Gastrointest Endosc

Patient-Related Adverse Events and Device Failures Associated with Commercially Available Enteral/Duodenal Self-Expanding Metal Stents: An Analysis of the MAUDE Database.

Both stents are associated with device failures such as failure to activate the stent, stent migration, and occlusion by tumor growth. Despite high success rates, duodenal stents can be associated with serious device failures and patient-related adverse events.

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J Hepatol

Mitochondrial alterations in fatty liver diseases.

Recent clinical studies assessed effects of diets or bariatric surgery on liver mitochondria, which are also currently evolving as interesting target to treat non-alcoholic fatty liver disease by using liver-directed thyroid hormone receptor agonists or protonophores. This review summarizes the current knowledge on hepatic mitochondria with a focus on fatty liver diseases due to obesity, type 2 diabetes and xenobiotics.

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Platform trials to overcome major shortcomings of traditional clinical trials in non-alcoholic steatohepatitis? Pros and Cons.

Through Bayesian interim analyses, these trials allow early exit of drugs from the trial based on success or futility, while providing participants better chances of receiving active compounds through adaptive randomization. Overall, platform trials represent an alternative for patients, pharmaceutical companies and clinicians in the quest for accelerating pharmacologic treatment for NASH.

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Neurogastroenterol Motil

Annotated translation of Georg Meissner's first description of the submucosal plexus.

Therefore, the main language in scientific literature of this field was German at the time, thus, limiting the accessibility to the publications and scientific discussions from back then for the broader English-speaking scientific community today. Purpose Here, an annotated translation of Meissner's first description of the submucosal plexus is provided along with a short biography of Georg Meissner and a review of the scientific literature and controversy surrounding his discovery.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Rare Portopulmonary Arteriovenous Fistula in a Cirrhotic Patient with Portal Hypertension and Inversion of Blood Flow after Liver Transplantation.

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ANEMIA RESISTANT TO THE GLUTEN-FREE DIET IN CELIAC DISEASE PATIENTS: IS IT JUST A MALABSORPTION PROBLEM?: ANEMIA RESISTANT TO GFD IN CD PATIENTS.

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Endometriosis of the Appendix, Cecum, and Ileum Masquerading as Suspected Crohn's Disease.

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Esophageal Apoplexy: A Rare Complication of Foreign-Body Ingestion.

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Healthcare Disparities in Gastroesophageal Reflux Disease for Hispanic and Latino Americans: A Solution-Oriented Approach for Improvement.

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Rupture splenic artery aneurysm caused by pancreatic cancer.

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Endoscopy

A release from WONderland: endoscopic ultrasonography-guided reconnection of disconnected pancreatic ducts across a walled-off necrosis cavity.

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Bile peritonitis after placement of a metallic stent in endoscopic ultrasound-guided hepaticogastrostomy: A pitfall and the rescue technique.

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Closure of full-thickness perforations in porcine stomach using 20-mm reopenable clips.

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Cystic duct stump stone removal by retrieval basket under direct visualization using a novel peroral choledochoscope.

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Endoluminal hemostasis of a Dieulafoy-like lesion of the gallbladder after endoscopic ultrasound-guided biliary drainage by a lumen-apposing stent.

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Gel-immersion electrohydraulic lithotripsy during digital single-operator cholangioscopy is helpful when bleeding occurs.

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Metal stenting for caustic esophageal injury with bronchoesophageal fistula.

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Miniprobe ultrasonography guidance during endoscopic submucosal dissection of an ampullary duodenal lesion.

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Self-expandable metallic stent deployment across the ileocecal valve in a patient with an acute colonic obstruction.

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Superficial nonampullary duodenal epithelial tumor: a rare case with signet-ring cell carcinoma component diagnosed by magnifying endoscopy.

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The role of macroscopic on-site evaluation in the era of biopsy needles: is it still useful?

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Use of texture and color enhancement imaging to identify the pancreatic duct orifice in a patient with a pancreaticojejunal anastomotic stricture.

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Gastroenterology

Autoimmune pancreatitis secondary to immune checkpoint inhibitor therapy (type 3 AIP): Insights into a new disease from serial pancreatic imaging.

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DISPARITIES IN ACCESS TO ENDOSCOPY FOR PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING PRESENTING TO EMERGENCY DEPARTMENTS.

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Endoscopist characteristics and polyp detection in colonoscopy: cross-sectional analyses of Screening of Swedish Colons.

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Patients with Gastrointestinal Conditions Consider Telehealth Equivalent to In-person Care.

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Gastrointest Endosc

A case of pseudomelanosis duodeni that disappeared after discontinuation of iron pills.

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IMPACT OF WITHDRAWAL TIME ON ADENOMA DETECTION RATE: RESULTS FROM A PROSPECTIVE, MULTI-CENTER TRIAL.

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Use of the BougieCap Device for Duodenal Stricture Dilation.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: colorectal cancer in elderly-onset IBD-what is the risk? Authors' reply.

Pubmed   Journal   ReadQx 

Letter: fighting the battle but losing the war-inflammatory bowel disease and venous thromboembolism.

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Letter: fighting the battle but losing the war-inflammatory bowel disease and venous thromboembolism. Authors' reply.

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Letter: immune-mediated inflammatory diseases and inflammatory bowel disease-are we ready for a Copernican revolution?

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Clin Gastroenterol Hepatol

Inflammatory Bowel Disease and Incident Acute Arterial Events.

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Gastroenterology

Proton pump inhibitors and mortality.

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Vonoprazan may induce Clostridium difficile infection and nephrotoxicity.

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Gut

Dynamic changes in host immune system and gut microbiota are associated with the production of SARS-CoV-2 antibodies.

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Response to letter to the editor: lumen-apposing metal stents versus double-pigtail plastic stents for infected necrotising pancreatitis.

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Response to Mansoor et al: 'epidemiology of inflammatory bowel disease in men with high-risk homosexual activity'.

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Role of the DOMINO diet application for managing IBS in primary care and beyond.

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J Hepatol

Albumin for cognitive impairment after TIPS: a road to be explored.

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Is NAFLD a Key Driver of Brain Dysfunction?

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Letter to the Editor - Reply to 'Ammonia - an old friend with a new area of application.

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Neurogastroenterol Motil

Author response to letter to the editor.

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